Leblanc H, Thote A, Chatellier G, Passa P
Service de Diabérologie Endocrinologie, Hôpital Saint Louis, Paris, France.
Diabete Metab. 1990 Mar-Apr;16(2):93-7.
To assess the effect of Glipizide on glycaemic control and peripheral insulin sensitivity, 9 type 1 (insulin dependent) diabetic patients with normal BMI, mean age 42.1 +/- 11.0 years, diabetes duration 16.3 +/- 9.2 years were studied. They were treated by continuous subcutaneous insulin infusion for a mean duration of 32.2 +/- 11.0 months, they were in good glycaemic control (mean HbA1 7.9 +/- 1.2%, upper limit of normal value 7.5%). In a double blind randomized control study they were successively allocated for a three month period to 15 mg of Glipizide daily or a Placebo. At the end of each period the following parameters were recorded: HbA1, mean plasma glucose levels, daily insulin dosage: basal rate and pre prandial bolus, peripheral insulin sensitivity assessed by euglycaemic hyperinsulinic clamp technique, the addition of Glipizide did not induce any statistically significant modification of HbA1, glycaemic values, and daily insulin dosage: basal rate 18.2 +/- 8.7 vs. 17.9 +/- 7.3 IU/24 hours and pre prandial bolus 18.6 +/- 7.0 vs 17.6 +/- 6.3 IU/24 hours. During the glucose clamp, glucose uptake was similar under Glipizide or Placebo with the 3 levels of insulin infused. These results suggest that in type 1 diabetic patients the addition of Glipizide to insulin therapy does not alter glycaemic control and peripheral insulin sensitivity.
为评估格列吡嗪对血糖控制及外周胰岛素敏感性的影响,我们对9名1型(胰岛素依赖型)糖尿病患者进行了研究,这些患者体重指数(BMI)正常,平均年龄42.1±11.0岁,糖尿病病程16.3±9.2年。他们接受持续皮下胰岛素输注治疗,平均时长为32.2±11.0个月,血糖控制良好(平均糖化血红蛋白[HbA1]为7.9±1.2%,正常值上限为7.5%)。在一项双盲随机对照研究中,他们被先后分配接受为期三个月的每日15毫克格列吡嗪治疗或安慰剂治疗。在每个治疗阶段结束时,记录以下参数:HbA1、平均血浆葡萄糖水平、每日胰岛素剂量(基础率和餐前大剂量),通过正常血糖高胰岛素钳夹技术评估外周胰岛素敏感性。添加格列吡嗪后,HbA1、血糖值及每日胰岛素剂量均未发生任何具有统计学意义的改变:基础率分别为18.2±8.7与17.9±7.3国际单位/24小时,餐前大剂量分别为18.6±7.0与17.6±6.3国际单位/24小时。在葡萄糖钳夹过程中,在输注3种胰岛素水平时,格列吡嗪组和安慰剂组的葡萄糖摄取情况相似。这些结果表明,在1型糖尿病患者中,胰岛素治疗添加格列吡嗪不会改变血糖控制及外周胰岛素敏感性。